Abstract
Purpose :
We have reported the prevalence of drusen subtypes (soft drusen, pachydrusen, and pseudodrusen) with the Rumoi study, a population-based study in Japan. In the current study, we aim to elucidate the risk and protective factors of drusen subtypes.
Methods :
In the Rumoi study, we took color fundus photographs of participants aged 40 years or older for 5 years yearly. We used first-year observation as a cross-sectional analysis. We compared characters of subjects who had each drusen subtype and those who didn’t. We also compared the differences in the characters among participants who had different drusen subtypes. In addition, we analyzed risk factors to develop drusen de novo in five years. We imputed missing values with the multiple imputation method, performed logistic regression or Cox proportional hazard regression to adjust for age and gender, and combined results using Rubin’s rule with utilizing statistical computing R.
Results :
Among 1,660 participants, whose fundus photographs could be evaluated, 99 showed soft drusen, 172 showed pachydrusen, and 27 showed pseudodrusen at least unilateral eye. Older age was a risk factor for the presence of all drusen subtypes (p<0.001). The presence of retinal pigment epithelium (RPE) abnormalities in the fundus was also the risk for soft drusen and pachydrusen (p<0.001). The participants who had pachydrusen smoked more cigarettes (p=0.02), drank more alcohol (p=0.01) and had higher diastolic pressure (p=0.03) than those without pachydrusen. Medication for hypertension and medication for diabetes were protective factors for pachydrusen (p=0.03). Gender women (p=0.03), low body mass index (p=0.002), and low body fat (p=0.02) were risk factors for the presence of pseudodrusen. Among drusen subtypes, the presence of RPE abnormalities was less likely to be associated with pseudodrusen than soft drusen (p=0.008), and anti-hypertensive medication was more protective for pachydrusen than soft drusen (p=0.04). Participants with pseudodrusen were significantly older (p=0.03), likely female gender, and had lower BMI than the other drusen subtypes (p<0.05). Among 1636 participants who didn’t have soft drusen in the first year, 39 participants demonstrated soft drusen de novo during 5 years. Smoking number (p=0.02) was related to newly developed soft drusen.
Conclusions :
There are similarities and differences in the risk and protective factors among drusen subtypes.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.